| NPI | 1144238353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08003546A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038008358) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-04 |