| NPI | 1184723108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034471) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 27 3547) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |