| NPI | 1003098658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9373) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2022-03-29 |