| NPI | 1336438084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch10150) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 5515) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-07-06 |