| NPI | 1467584201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: MN 003337) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 003337) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2025-09-11 |