| NPI | 1275849424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 10065) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PR 535) |
| 111N00000X Chiropractor (Licence: AZ 8568) | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2020-05-13 |