| NPI | 1356351472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NH 52-A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 0673) |
| 111N00000X Chiropractor (Licence: GA 001047) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |