| NPI | 1700843828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034083) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 27 3321) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2008-04-04 |