| NPI | 1184909145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3545) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 10430) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2016-10-27 |