| NPI | 1427267301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 248783) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: HI 1110) |
| 111N00000X Chiropractor (Licence: KY 4876) | |
| 111N00000X Chiropractor (Licence: IA 06323) | |
| 111N00000X Chiropractor (Licence: WV 1069) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-01-29 |