| NPI | 1528281284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 713673) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034621) |
| 111N00000X Chiropractor (Licence: CA DC27397) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2009-04-15 |