| NPI | 1104806579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH2440) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH2440) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2010-07-28 |