| NPI | 1093737298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 295461) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC29546) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-12-07 |