| NPI | 1043871718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: CA 34549) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 34549) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 34549) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2026-03-24 |