| NPI | 1962512376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: CA 17262) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: CA 0172620) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-03-24 |