| NPI | 1568437903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC25405) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 8624) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-10-06 |