| NPI | 1124345327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 4058) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9976) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2023-04-03 |