| NPI | 1073514436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 3676) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL CH 3676) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH 3676) | |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH 3676) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-09-09 |