| NPI | 1184714693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: NV B-223) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B-223) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-10-03 |