| NPI | 1932159928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: MI JK008789) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MI JK008789) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-02-16 |