| NPI | 1265752083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: FL CH12097) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: CO CHR.0008541) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2022-09-22 |