| NPI | 1871726927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 001814) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60166028) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2024-10-18 |