| NPI | 1629052097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0004640) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: FL CH 4640) |
| 111NS0005X Chiropractor, Sports Physician (Licence: FL CH 4640) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2018-07-03 |