| NPI | 1730215203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC1331) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 6833) |
| 111N00000X Chiropractor (Licence: WA 2630) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-06-14 |