| NPI | 1952476012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA choooo2189) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA nt00000944) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2010-06-14 |