| NPI | 1841888658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1531) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 6124) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2023-05-09 |