| NPI | 1497127609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC33407) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 33407) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2020-12-22 |