| NPI | 1497924526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 31081) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 71-3813) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2015-02-05 |