| NPI | 1285065664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60342429) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC32398) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |