| NPI | 1639476195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV b170) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 12393) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-02-18 |