| NPI | 1710037874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH00034706) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60506236) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-12-15 |