| NPI | 1700918885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch9021) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301007330) |
| 111N00000X Chiropractor (Licence: DE F1-0000697) | |
| 111N00000X Chiropractor (Licence: MO 2020030365) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2024-01-02 |