| NPI | 1427019496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0006236) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X006058) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2012-06-29 |