| NPI | 1346365749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9974) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 3212) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-11-06 |