| NPI | 1356670749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch9840) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA chir008512) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2014-04-21 |