NPI | 1063088565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34691) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: CA 34691) |
Enumeration Date | 2021-06-03 |
Last Update Date | 2022-11-27 |