| NPI | 1083656946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH10005) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X008467-1) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2022-06-28 |