| NPI | 1962573741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7088) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: AZ 01-608d) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2015-10-28 |