| NPI | 1801865829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7921) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP2044) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2017-08-17 |