| NPI | 1427502459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11988) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X012721) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-10-18 |