| NPI | 1982283115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: ID 8961561) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: MN 6842) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2024-08-16 |