| NPI | 1487323119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC36911) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR010559) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-03-13 |