| NPI | 1538290143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1213) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: UT 346128-1202) |
| 225700000X Massage Therapist (Licence: HI MAT-17235) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-10-12 |