| NPI | 1669614426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC27718) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA DC27718) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: CA DC27718) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: CA DC27718) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |