| NPI | 1437583903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 33998) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012492) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 33998) | |
| Enumeration Date | 2013-09-02 |
| Last Update Date | 2025-05-29 |