| NPI | 1003448200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06245) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH61032328) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2023-05-10 |