| NPI | 1093043655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NE 1578) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NE 1578) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2022-10-19 |