| NPI | 1821229337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 5226) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA chir008488) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2013-08-19 |