| NPI | 1851491500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: SC 1063) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NY X004673-1) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2025-09-11 |