| NPI | 1497159941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60498261) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC61446291) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2026-02-23 |