| NPI | 1306037650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC26406) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch8631) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2012-11-19 |