| NPI | 1922332121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01351) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-31339) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |