| NPI | 1831234996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC SC2608) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9562) |
| 111N00000X Chiropractor (Licence: DE F1-0000821) | |
| 111N00000X Chiropractor (Licence: SC 2608) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2022-06-23 |