| NPI | 1518001098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-05063) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: KS 01-05063) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |