| NPI | 1932329109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 00034766) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034766) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2025-06-12 |