| NPI | 1184846180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CA DC 25501) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 25501) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: CA DC 25501) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2025-09-11 |