| NPI | 1669597605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 3666) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034255) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-12-21 |