| NPI | 1811198054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7063) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 02688) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2008-06-26 |