| NPI | 1336796820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN CH7570) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002809A) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |