| NPI | 1033294392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 048) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 2942) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2018-09-14 |