| NPI | 1528712239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH.61257998) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA 61257998) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |