| NPI | 1457619827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH10518) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA Chir008910) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2013-09-25 |