| NPI | 1881773851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01549) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-30215) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2014-12-18 |