| NPI | 1851609127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 4925) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AZ 0183) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2010-09-20 |