| NPI | 1245213008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC1401) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AK 413) |
| 111N00000X Chiropractor (Licence: ID CHIA-1344) | |
| 111N00000X Chiropractor (Licence: AZ 7633) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2018-06-05 |