| NPI | 1184067050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B02018) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-05495) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2024-10-08 |