| NPI | 1366496135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH8750) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL CH8750) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-09-28 |