| NPI | 1598767642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: CA DC22376) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-02-25 |