| NPI | 1437235934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 061) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 3494) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2013-08-13 |