| NPI | 1992203509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PR 000947) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH12228) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2024-07-24 |