| NPI | 1073379137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: MT CHI-CHI-LIC-8719) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MT CHI-CHI-LIC-8719) |
| 111NN1001X Chiropractor, Nutrition (Licence: MT CHI-CHI-LIC-8719) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: TX CHI-CHI-LIC-8719) | |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |