| NPI | 1386069409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH61131051) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH12700) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2022-06-16 |