| NPI | 1295734879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B-924) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B924) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2017-03-24 |