| NPI | 1407254311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60506347) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA 60506347) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2020-01-10 |