| NPI | 1922208321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NV B01260) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: NV B01260) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-05-27 |