| NPI | 1427222132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 06962) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OK 3909) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2020-10-20 |