| NPI | 1437940939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 37168) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: CA 37168) |
| 111NR0400X Chiropractor Rehabilitation (Licence: CA 371658) | |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |