| NPI | 1851392013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 4945) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 06565) |
| 111N00000X Chiropractor (Licence: FL CH 8681) | |
| 111N00000X Chiropractor (Licence: IA 6565) | |
| 111N00000X Chiropractor (Licence: MN 5433) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-02-14 |