| NPI | 1568034346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14319) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ME CR2748) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2025-07-30 |