| NPI | 1932283439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR010268) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC25377) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-03-07 |