| NPI | 1467599266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7478) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 462) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2016-10-22 |