| NPI | 1902090756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14051) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2218) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2023-05-05 |