| NPI | 1386871986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: MI 2301005440) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: MI 2301005440) |
| 111NN1001X Chiropractor, Nutrition (Licence: MI 23201005440) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |