| NPI | 1477997203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11192) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD S03744) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2015-05-26 |