| NPI | 1598801003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 1642) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OK 3765) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-05-15 |