| NPI | 1225599723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14501) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIRO10143) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-05-01 |