| NPI | 1336548676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11321) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038012655) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2022-12-13 |