| NPI | 1255470753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: AZ AZ3768) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: AZ 3768) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2017-02-23 |