| NPI | 1336210954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 23741) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC23741) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-06-28 |