| NPI | 1558563502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: VA 0104556753) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: WA Ch00034663) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2009-12-28 |