| NPI | 1255748968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 11409) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR009340) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2022-05-26 |