| NPI | 1295702157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC25071) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: HI DC739) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2017-03-14 |