| NPI | 1326008152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11208) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4030-012) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-09-27 |