| NPI | 1932282878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor Occupational Health (Licence: AZ 8098) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: CA DC28876) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-05-23 |