| NPI | 1326088527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP21894) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 16831) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2012-07-13 |