| NPI | 1639132293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00001690) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: WA CH1690) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-09-11 |