| NPI | 1730261223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 806) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08000625A) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |