| NPI | 1497885867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 12318) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034705) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-02-06 |