| NPI | 1144461294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC-31311) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 11161) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2021-07-28 |