| NPI | 1851680094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3578) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: SC 3578) |
| 111NN1001X Chiropractor, Nutrition (Licence: SC 3578) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2013-03-08 |