| NPI | 1881859098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC20684) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00003433) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2008-07-28 |