| NPI | 1639412927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH10909) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: PR 00610) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2015-07-16 |