| NPI | 1326476888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 16037) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: AR 16037) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: AR 16037) | |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2020-01-31 |