| NPI | 1427339993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 11305) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002592A) |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2025-10-28 |