| NPI | 1841056496 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34053) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: CA 34053) |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |