| NPI | 1427592591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34386) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60713159) |
| 111N00000X Chiropractor (Licence: MI 2301010548) | |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2019-03-20 |