| NPI | 1689406084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC17947) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 17947) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |