| NPI | 1194441279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC-1623) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 013667) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2026-04-29 |