| NPI | 1902334345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 4238) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: SC 4238) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2026-07-23 |