| NPI | 1295857308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 4413) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC29711) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2026-03-17 |