| NPI | 1548455546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 563) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034807) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2012-11-21 |