| NPI | 1295881423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7128) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 1732) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2009-03-10 |