| NPI | 1942279757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AR 794) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: AR 794) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2012-09-11 |