| NPI | 1548577927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34598) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: VA 0104556161) |
| 111N00000X Chiropractor (Licence: VA 0104556161) | |
| 111NN1001X Chiropractor, Nutrition (Licence: CA 34598) | |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2024-05-24 |