| NPI | 1427158138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch8144) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x009395) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2010-03-03 |