| NPI | 1891874822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC20606) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 20606) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-04-15 |