| NPI | 1437181658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 28744) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: HI DC 946) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-04-28 |