| NPI | 1760642524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 9561) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9561) |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2024-03-14 |