| NPI | 1033735519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2811) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH14054) |
| 111N00000X Chiropractor (Licence: TX 14429) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-07-18 |