| NPI | 1023894714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 3910) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 099.0134208) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2025-01-07 |