| NPI | 1891902888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: WI 1822) |
| Additional Taxonomies | 111NR0400X (Licence: WI 1822) |
| 171400000X Health & Wellness Coach (Licence: WI 1822) | |
| 172M00000X Mechanotherapist (Licence: WI 1822) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-05-11 |