| NPI | 1265009534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13499) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 13499) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2023-10-03 |