| NPI | 1922087923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch9112) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2819) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2025-10-23 |