| NPI | 1700903259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: WA ch00034479) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA chooo34479) |
| 111N00000X Chiropractor (Licence: WA ch00034479) | |
| 111NN0400X Chiropractor, Neurology (Licence: WA ch0034479) | |
| 111NN1001X Chiropractor, Nutrition (Licence: WA ch00034479) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-10-28 |