| NPI | 1578061305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH12851) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-05874) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2023-02-20 |