| NPI | 1437960234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CHIR.CH.70132853) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 16269) |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2026-07-07 |