| NPI | 1700020450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC795) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: HI DC 795) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |