| NPI | 1598836843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: ID CHIA1065) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ID chia1065) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2024-01-09 |