| NPI | 1295976462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: FL MA54290) |
| Additional Taxonomies | 173C00000X Reflexologist (Licence: FL MA54290) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |