| NPI | 1649215716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NT0100X Chiropractor, Thermography (Licence: MI 2301005069) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301005069) |
| 111NN0400X Chiropractor, Neurology (Licence: MI 2301005069) | |
| 111NN1001X Chiropractor, Nutrition (Licence: MI 2301005069) | |
| 111NR0200X Chiropractor, Radiology (Licence: MI 2301005069) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: MI 2301005069) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2025-09-11 |