| NPI | 1285729871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9245) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X008831-1) |
| 111N00000X Chiropractor (Licence: VA 0104555764) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-05-15 |