| 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 | 2025-09-11 |