| NPI | 1346441425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01211) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ID CHIA1186) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-09 |