| NPI | 1932677762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC28539) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 28539) |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |