| NPI | 1487952636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC-31289) |
| Additional Taxonomies | 111NT0100X Chiropractor, Thermography (Licence: CA DC-31289) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2016-02-16 |