| NPI | 1134242357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 4098) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 14819) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-09-23 |