| NPI | 1568624674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 1472) |
| Additional Taxonomies | 111NT0100X Chiropractor Thermography (Licence: AL 1472) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |