| NPI | 1083735955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0007161) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps42127) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2011-11-02 |