| NPI | 1831954106 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: MN 7058) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 7058) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |