| NPI | 1538131438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: AL 2117) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2117) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2015-07-08 |