| NPI | 1417013111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2002017055) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA 2572) |
| 175F00000X Naturopath (Licence: WA 801) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-09-28 |