| NPI | 1538388244 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0005425) | 
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH0005425) | 
| Enumeration Date | 2007-04-24 | 
| Last Update Date | 2020-12-23 |