| NPI | 1992824023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor Neurology (Licence: NY X009972-1) |
| Additional Taxonomies | 111NN1001X Chiropractor Nutrition (Licence: NY X009972-1) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-07-20 |