| NPI | 1356320113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08001674A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28270166C) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71015126A) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2024-05-10 |