| NPI | 1467998955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: MN 6541) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60713471) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2020-09-14 |