| NPI | 1548338627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: CA DC24551) |
| Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: CA DC24551) |
| 111NX0100X Chiropractor Occupational Health (Licence: CA DC24551) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-11-25 |