| NPI | 1396203949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13338) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: WA NATU.NT.60836681) |
| 225700000X Massage Therapist (Licence: FL MA88753) | |
| Enumeration Date | 2019-03-02 |
| Last Update Date | 2021-05-24 |