| NPI | 1831499193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 10079) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x005255) |
| 202D00000X Integrative Medicine (Licence: FL CH10079) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2022-09-17 |