| NPI | 1447245618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: CA DC28489) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC007752L) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2017-04-25 |