| NPI | 1295456218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14204) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 14204) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-08-15 |