| NPI | 1932439221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PR 992) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: PR 2790) |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2024-04-05 |