| NPI | 1407543788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI D-1565) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC36549) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-24 |