| NPI | 1003375726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC37479) |
| Additional Taxonomies | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: CA RN95439268) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2026-02-10 |