| NPI | 1538255393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC 27533) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 5604) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-02-05 |