| NPI | 1316427669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14052) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 14863) |
| 111N00000X Chiropractor (Licence: CA 34240) | |
| 111N00000X Chiropractor (Licence: AK 185611) | |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2026-02-18 |