| NPI | 1881729689 |
|---|---|
| Former Name | DAVID REVIVO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26801) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA DC26801) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2014-01-23 |