| NPI | 1275607673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00002389) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 19935) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-03-29 |