| NPI | 1528244332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6220) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034856) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2018-02-20 |