| NPI | 1922350321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: WA CH60542353) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: WA CH60542353) |
| 111N00000X Chiropractor (Licence: WA CH60542353) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2024-11-21 |