| NPI | 1881163467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH.60979655) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2018040678) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2024-06-24 |