| NPI | 1033749627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13285) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 16570) |
| 111N00000X Chiropractor (Licence: GA CHIR011207) | |
| 111N00000X Chiropractor (Licence: NY X013888-01) | |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2026-05-27 |