| NPI | 1174611396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: IN 08001418A) |
| Additional Taxonomies | 111NR0200X Chiropractor Radiology (Licence: IN 08001418A) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-12-07 |