| NPI | 1093805178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11178) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034742) |
| 111N00000X Chiropractor (Licence: OR 713689) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-01-14 |