| NPI | 1225565252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH12071) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH12071) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2022-07-21 |