| NPI | 1033287040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: ID 508) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: ID 508c) |
| 111NX0800X Chiropractor, Orthopedic (Licence: ID 508c) | |
| 175F00000X Naturopath (Licence: ID 508) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2016-03-01 |