| NPI | 1295879526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AK 306) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: AK 306) |
| 111NN1001X Chiropractor, Nutrition (Licence: AK 306) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: AK 306) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: AK 306) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-07-08 |