| NPI | 1427037886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NH 5000997) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 2180) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2013-01-02 |