| NPI | 1215707047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14859) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 14859) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-06-10 |