| NPI | 1922384056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: PR 501) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 11839) |
| 111N00000X Chiropractor (Licence: PR 501) | |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2025-07-30 |