| NPI | 1689824344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV BO1357) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 11944) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2011-01-03 |