| NPI | 1871760777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60105606) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 30907) |
| Enumeration Date | 2008-05-11 |
| Last Update Date | 2019-10-14 |