| NPI | 1053598607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 3948) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC00003038) |
| 111N00000X Chiropractor (Licence: WA CH00034825) | |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2009-10-07 |