| NPI | 1578527081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 27-3267) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00003342) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2008-03-06 |