| NPI | 1821234436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: CT 001112) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CT 001112) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2009-01-02 |