| NPI | 1154542710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00033960) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: OR 27 2853) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |