| NPI | 1225105463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0005779) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 8129) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2024-03-15 |