| NPI | 1437149283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 06501) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: IA 06501) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2008-07-02 |