| NPI | 1750446407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: CA DC26511) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: CA DC26511) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2007-12-27 |