| NPI | 1235132218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH1981) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104000614) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-12-10 |