| NPI | 1982318853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06317) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08003362A) |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2024-05-13 |