| NPI | 1972356160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: HI DC-1580-0) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 15828) |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |