| NPI | 1881605061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 003544) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MO 003544) |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: MO 003544) | |
| 171100000X Acupuncturist (Licence: MO 003544) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-06-15 |