| NPI | 1144274994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: MD S01909-PT) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD S01909 PT) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: MD S01909-PT) | |
| 111NN0400X Chiropractor, Neurology (Licence: MD S01909-PT) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: MD S01909-PT) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-04-23 |