| NPI | 1225819253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC-1600-0) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 36775) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-05-16 |