| NPI | 1447233044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08001243A) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: IN 08001243A) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2011-10-18 |