| NPI | 1497868129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 2793) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA 307) |
| 175F00000X Naturopath (Licence: WA 778) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2014-03-06 |