| NPI | 1295006831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC31548) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 31548) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2022-05-11 |