| NPI | 1003904210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: IN 08001646) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: IN 08001646) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-03-25 |