| NPI | 1740660026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: FL CH12342) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 12944) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2019-07-12 |