| NPI | 1316933047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2291) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8126) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2024-01-18 |