| NPI | 1346329950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301002835) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH6951) |
| 111N00000X Chiropractor (Licence: MO 003982) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |