| NPI | 1427009620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9101) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL Ch9101) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-11-20 |