| NPI | 1538339734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08002583A) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: GA CHIR007127) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2011-06-10 |