| NPI | 1922283902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: CA DC30668) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2013-07-22 |