| NPI | 1437278942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: MN 1721) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 1721) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-07-01 |