| NPI | 1598581886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CHIR.CH.70126309) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC36969) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2026-06-01 |