| NPI | 1457437287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9671) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA GACHIRO07789) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-03-18 |