| NPI | 1700917531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC15057) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 15057) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-07-18 |