| NPI | 1659466340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor Neurology (Licence: AZ 7303) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 7303) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-03-28 |