| NPI | 1558995027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8899) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: AZ 8899) |
| 111NX0800X Chiropractor, Orthopedic (Licence: AZ 8899) | |
| 111NI0900X Chiropractor, Internist (Licence: AZ 8899) | |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: AZ 8899) | |
| 111NR0400X (Licence: AZ 8899) | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2024-02-22 |