| NPI | 1649889866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34886) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NM DC2268) |
| 111N00000X Chiropractor (Licence: NM DC2268) | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2026-01-14 |