| NPI | 1215186218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR0008476) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9610) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2020-12-03 |