| NPI | 1417093089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch0003767) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL ch0003767) |
| 111NN1001X Chiropractor, Nutrition (Licence: FL ch0003767) | |
| 111NR0200X Chiropractor, Radiology (Licence: FL ch0003767) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: FL ch0003767) | |
| 111NT0100X Chiropractor, Thermography (Licence: FL ch0003767) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-09 |