| NPI | 1386839827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 545) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 02) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-08 |