| NPI | 1902837958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 12025) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301007757) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-11-07 |