| NPI | 1164193595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 0000003434) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08003246A) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2021-09-24 |