| NPI | 1902005770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 3744) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: OR 1886) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2012-04-11 |