| NPI | 1811177009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0100X Chiropractor, Occupational Health (Licence: OH 3841) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 3841) |
| 111NN0400X Chiropractor, Neurology (Licence: OH 3841) | |
| 111NN1001X Chiropractor, Nutrition (Licence: OH 3841) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: OH 3841) | |
| 111NT0100X Chiropractor, Thermography (Licence: OH 3841) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: OH 3841) | |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2018-08-25 |