| NPI | 1336207620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7568) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 6333) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-03-07 |