| NPI | 1568598613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 1022) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: AR 1022) |
| 111NN0400X Chiropractor, Neurology (Licence: AR 1022) | |
| 111NN1001X Chiropractor, Nutrition (Licence: AR 1022) | |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: AR 1022) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: AR 1022) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2020-01-15 |