| NPI | 1588766109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN TN1988) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 1988) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2023-02-02 |