| NPI | 1023258548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA dc31153) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 139483) |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2023-07-11 |