| NPI | 1730377755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 18794) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN223997) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2009-12-01 |