| NPI | 1164657466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03734) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: DC CH030091) |
| 111N00000X Chiropractor (Licence: CA DC31251) | |
| Enumeration Date | 2009-05-16 |
| Last Update Date | 2024-01-03 |