| NPI | 1740237700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 23577) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC23577) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-04-01 |