| NPI | 1316054729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC21780) |
| Additional Taxonomies | 111NT0100X Chiropractor, Thermography (Licence: CA DC21780) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-08-15 |