| NPI | 1891991089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC21923) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2019-11-09 |