| NPI | 1912898834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CHIR.CH.70018309) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC37344) |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |