| NPI | 1609661693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1644) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC37205) |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-12-10 |