| NPI | 1043224181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1366) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5186) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-11-29 |