| NPI | 1275770919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 4906) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 05-878) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-02-02 |