| NPI | 1629135967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CT Ct001042) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CT CT001042) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2025-09-11 |