| NPI | 1851309991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: OR 1163) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 360) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2010-07-19 |