| NPI | 1467470443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 3047) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH-8948) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-12-21 |