| NPI | 1881910180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 5341) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9958) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-09-02 |