| NPI | 1881288488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1522) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 6135) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2022-06-30 |