| NPI | 1558581686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 4962) |
| Additional Taxonomies | 111NT0100X Chiropractor, Thermography (Licence: AZ 2736) |
| 171100000X Acupuncturist (Licence: AZ 394) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2008-03-05 |