| NPI | 1346693439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH12981) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 33644) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2020-11-23 |