| NPI | 1235345943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: CA DC18757) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: CA DC18757) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA DC18757) | |
| 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: CA MTA22600) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |