| NPI | 1144040874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 6418) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH61610862) |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-11-02 |