| NPI | 1023194339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034786) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 6129) |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2014-03-13 |