NPI | 1700202512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 32893) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA 32893) |
Enumeration Date | 2014-03-17 |
Last Update Date | 2025-03-05 |