| NPI | 1427047307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 6360) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR004879) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-07-27 |