NPI | 1467570804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: CA D.C0175130) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 17513) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2025-08-22 |