| NPI | 1871747485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3406) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC BLC1505843) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2024-02-20 |