| NPI | 1447226592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: CA DC-27648) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 27648) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-08-10 |