| NPI | 1205473287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: FL CH13447) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 34491) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2023-08-29 |