| NPI | 1225030158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH2871) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT805) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2012-12-06 |