| NPI | 1538462452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR0006664) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA ch60151330) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2018-06-20 |