| NPI | 1922370188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01459) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32168) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2021-12-16 |