| NPI | 1912438128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC34265) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 34265) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-02-20 |