| NPI | 1316282544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC-1273) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.012301) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2014-06-13 |