| NPI | 1407944606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 3897) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: IN IN08001209) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IN IN08001209) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2017-04-26 |