| NPI | 1043323249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00003420) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH3420) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2012-05-07 |