| NPI | 1346317971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034417) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 283580) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-04-30 |