| NPI | 1316936206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7882) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2398) |
| 111N00000X Chiropractor (Licence: GA 6191) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2016-03-23 |