| NPI | 1497348411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC36036) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC36033) |
| Enumeration Date | 2021-02-20 |
| Last Update Date | 2021-03-04 |