| NPI | 1144884305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV b01936) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR010191) |
| 111N00000X Chiropractor (Licence: CA 34893) | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-01-10 |