| NPI | 1598432445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH61499339) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 36017) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2024-04-23 |