| NPI | 1063876837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: MI 2301011001) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009578) |
| 111NN0400X Chiropractor, Neurology (Licence: FL CH11652) | |
| 111NN0400X Chiropractor, Neurology (Licence: ME CR2344) | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2021-06-03 |