| NPI | 1821299546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH 60506492) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC30242) |
| 111N00000X Chiropractor (Licence: ID CHIA 1456) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2014-11-06 |