| NPI | 1144229923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1545) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 27511) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2023-07-13 |