| NPI | 1427352103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8168) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 28609) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2017-07-12 |