| NPI | 1346464690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CA DC22169) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-12-12648) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2012-12-14 |