| NPI | 1114138336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA ch00033709) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT00001183) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2007-07-08 |