| NPI | 1427257906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor Independent Medical Examiner (Licence: SC DC 4093) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC 30405) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2016-09-22 |