| NPI | 1982408274 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CA DC36831) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: CA RHC00207972) |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-04-03 |