| NPI | 1154630069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CHIR.CH.60836756) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT60736006) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2022-06-15 |