| NPI | 1376733030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 9374) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: FL CH9374) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH9374) | |
| 225700000X Massage Therapist | |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH9374) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2024-11-22 |