| NPI | 1487453429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 234701) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08003424A) |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-06-30 |