| NPI | 1376634303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002866A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC23621) |
| 111N00000X Chiropractor (Licence: CT 00573) | |
| 111N00000X Chiropractor (Licence: ID CHIA-517) | |
| 111N00000X Chiropractor (Licence: CO CHR6673) | |
| 111N00000X Chiropractor (Licence: IL 038-004945) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-08-23 |