| NPI | 1154515757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH5961) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH 5961) |
| 111NN1001X Chiropractor, Nutrition (Licence: FL CH 5961) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: FL CH 5961) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |