| NPI | 1407994825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 2406) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH0005083) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2022-06-24 |