| NPI | 1114043247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 27-3241) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: OR 27-3241) |
| 175F00000X Naturopath (Licence: OR 1062) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2019-06-11 |