| NPI | 1669501151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 4410) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9141) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2024-02-27 |