| NPI | 1568649044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4468-012) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: WI 4468-012) |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2010-08-18 |