| NPI | 1548145543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH15800) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-06416) |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2026-03-03 |