| NPI | 1447567086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301401665) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 10618) |
| 111N00000X Chiropractor (Licence: IL 038011763) | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2025-11-13 |