| NPI | 1265501357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 16337) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B1039) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-12-20 |