| NPI | 1598389249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08003326A) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2020014160) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2022-09-07 |