| NPI | 1750693610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor Independent Medical Examiner (Licence: CA 15422) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 15422) |
| 111NN1001X Chiropractor Nutrition (Licence: CA 15422) | |
| 111NR0400X Chiropractor Rehabilitation (Licence: CA 15422) | |
| 111NT0100X Chiropractor Thermography (Licence: CA 15422) | |
| 111NX0100X Chiropractor Occupational Health (Licence: CA 15422) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-11-23 |