| NPI | 1326251034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV b-01027) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA dc 30090) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-06-16 |