| NPI | 1376720656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: IN 08000425A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000425A) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |