| NPI | 1992451561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13638) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 13638) |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2025-05-21 |