| NPI | 1699711077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC-13956) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: CA QME 006232) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-02-15 |