| NPI | 1326060260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CM34140) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: WA CM34140) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2024-02-22 |