| NPI | 1457783011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor Occupational Health (Licence: CA 20642) |
| Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: CA 20642) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |