| NPI | 1174959977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002727A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012402) |
| 111N00000X Chiropractor (Licence: IA 007695) | |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |