| NPI | 1043423825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor Independent Medical Examiner (Licence: CA CA18846) |
| Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: CA 18846) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |