| NPI | 1427188895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 1362) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 1498) |
| 111N00000X Chiropractor (Licence: HI 489) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |