| NPI | 1144985656 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14729) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 6905) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2024-11-12 |