| NPI | 1386820991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002910A) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: CA DC27270) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2023-12-29 |