| NPI | 1740605054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: RI DCP00636) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA chir009268) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-08-06 |