| NPI | 1750399044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: FL CH0003597) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH3597) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-05-25 |