| NPI | 1841489887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IN 08002356a) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: AL 2201) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |