| NPI | 1124062849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034279) |
| Additional Taxonomies | 111NI0013X Chiropractor Independent Medical Examiner (Licence: WA CH00034279) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-10-10 |