| NPI | 1285737726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B00614) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 5291) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-05-28 |