| NPI | 1659948917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13527) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 13527) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-06-07 |