| NPI | 1508845785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 1276) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AR 1276) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2024-03-07 |