| NPI | 1346333242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7753) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-008647) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2011-11-29 |