| NPI | 1053588046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14540) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002368A) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2023-05-30 |