| NPI | 1497741102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08001953A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI L557714) |
| 171100000X Acupuncturist (Licence: IN 81000026A) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2007-07-08 |