| NPI | 1427483809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01464) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32278) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |