| NPI | 1437592805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: AK 561) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AK 561) |
| 111NN1001X Chiropractor, Nutrition (Licence: AK 561) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2022-03-31 |