| NPI | 1467692525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26689) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 26689) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2025-01-02 |