| NPI | 1093840001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9391) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 0038-008447) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2013-03-25 |