| NPI | 1508979154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH6315) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: FL AS5345) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-07-19 |