| NPI | 1922144773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-699) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00002763) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2014-01-21 |