| NPI | 1487809158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MT 87704) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 5179) |
| 111N00000X Chiropractor (Licence: IN 08002411A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 111N00000X Chiropractor (Licence: FL CH 9979) | |
| Enumeration Date | 2008-11-23 |
| Last Update Date | 2020-06-03 |