| NPI | 1871542951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: FL CH2508) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH2508) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |