| NPI | 1841470812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC22598) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7206) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |