| NPI | 1598053431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 22693) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: CA 22693) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-07-13 |