| NPI | 1730269317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: CT 000172) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CT 000282) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2009-03-10 |