| NPI | 1497088074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 31353) |
| Additional Taxonomies | 111NT0100X Chiropractor, Thermography (Licence: CA 31353) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2016-09-13 |