| NPI | 1265641849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01699) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 22338) |
| 111N00000X Chiropractor (Licence: CA DC22338) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-05-02 |