| NPI | 1730244781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8257) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002221A) |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: AZ 2192) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-08-31 |