| NPI | 1649379439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034519) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60127707) |
| 111N00000X Chiropractor (Licence: CA 29810) | |
| 171100000X Acupuncturist (Licence: CA 11401) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-02-13 |