| NPI | 1295848380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: FL CH9014) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL CH9014) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2015-10-08 |