| NPI | 1245408657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 786) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV b-442) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2023-04-03 |