| NPI | 1851590947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 22848) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: CA 22848) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2008-09-16 |