| NPI | 1326008079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV B00949) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B00949) |
| 111NN1001X Chiropractor, Nutrition (Licence: NV B00949) | |
| Enumeration Date | 2006-03-26 |
| Last Update Date | 2013-09-17 |