| NPI | 1083037428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 11946) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0007086) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2017-05-11 |