| NPI | 1316096282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA BC23608) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104001706) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-04-29 |