| NPI | 1457546566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 26863) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 268630) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |