| NPI | 1235360348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 28926) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: CA RHC 00163187) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2012-12-13 |