| NPI | 1235140351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13501) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38mc00649400) |
| 111N00000X Chiropractor (Licence: NY 009573) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2022-01-12 |