| NPI | 1699093633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-2114) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MT chi-chi-lic-1841) |
| Enumeration Date | 2010-05-15 |
| Last Update Date | 2024-11-27 |