| NPI | 1740392083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH 2085) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NT 558) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-07-26 |