| NPI | 1265071641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC-1635-0) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X01332501) |
| 111N00000X Chiropractor (Licence: CO CHR.0008144) | |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2025-08-25 |