| NPI | 1326440058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-0000935) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: GA CHIR008604) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2024-01-16 |