| NPI | 1093740904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00033608) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2235) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-01-04 |