| NPI | 1003038977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: WA CH60022455) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60022455) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: WA CH60022455) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: WA CH60022455) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-06-09 |