| NPI | 1003026485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH3178) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL AP1911) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2010-05-19 |