| NPI | 1942074349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1562) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 35154) |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |