| NPI | 1114197860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26249) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: CA DC26249) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2009-02-25 |