| NPI | 1851957237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34440) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR0008703) |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2024-05-06 |