| NPI | 1033173018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9029) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 9029) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2018-06-05 |