| NPI | 1952478505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 29226) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC29226) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-04-09 |