| NPI | 1366816225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CA 20171192) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 33545) |
| 111N00000X Chiropractor (Licence: NY x012742-1) | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2022-01-17 |