| NPI | 1699139279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: MI 2301011000) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH11461) |
| 111NN0400X Chiropractor, Neurology (Licence: GA CHIR009527) | |
| 111NN0400X Chiropractor, Neurology (Licence: ME CR2339) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2021-06-03 |