| NPI | 1285747709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC29149) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95029498) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-05-01 |