| NPI | 1699530766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172P00000X Naprapath (Licence: NM DN2024-003) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NM DN2024-0003) |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-29 |