| NPI | 1598837478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8311) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002289A) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-03-30 |