| NPI | 1093145278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: TX 12881) |
| Additional Taxonomies | 111NR0400X (Licence: FL CH11058) |
| 111NS0005X Chiropractor, Sports Physician (Licence: FL CH11058) | |
| 111N00000X Chiropractor (Licence: FL CH11058) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2023-10-04 |