| NPI | 1437509536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34816) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SD 1290) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-08-17 |