| NPI | 1194861070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH0000237) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: WA CH00002377) |
| 111NR0200X Chiropractor, Radiology (Licence: WA CH00002377) | |
| 111NR0400X (Licence: WA CH00002377) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: WA CH00002377) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: WA CH00002377) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: WA CH00002377) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-11-04 |