| NPI | 1700077708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI HI-1348) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA 007114) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2022-02-21 |