| NPI | 1902651649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06324) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-0632) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |