| NPI | 1326068297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5445) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 3551) |
| 111N00000X Chiropractor (Licence: NJ 38MC00536800) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-11-07 |