| NPI | 1881708675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26236) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B-773) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2010-06-25 |