| NPI | 1427088087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 319) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: UT 349809-1202) |
| 111N00000X Chiropractor (Licence: NV B00812) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-11-27 |