| NPI | 1437543808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S03830) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: MD S03830) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2023-12-08 |