| NPI | 1215616149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: FL CH14605) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: FL CH14605) |
| 111NX0100X Chiropractor, Occupational Health (Licence: FL CH14605) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: FL CH14605) | |
| 111NN0400X Chiropractor, Neurology (Licence: FL CH14605) | |
| 111N00000X Chiropractor (Licence: FL CH14605) | |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH14605) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH14605) | |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2025-11-23 |