| NPI | 1891850459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B498) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B498 295368-1202) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2009-03-20 |