| NPI | 1215091863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA964) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: ID 1071256) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2026-03-12 |