| NPI | 1356643183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11606) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008754) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2017-01-24 |