| NPI | 1427122217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9399) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X0045601) |
| 111N00000X Chiropractor (Licence: SC 3198) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2009-03-17 |