| NPI | 1346386406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MT 590) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC19611) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-12-05 |