| NPI | 1437354511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11011) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC30218) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-03-13 |