| NPI | 1538281324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA CADC15469) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC15469) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2010-05-28 |