| NPI | 1487623054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9357) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: LA 1286) |
| 111N00000X Chiropractor (Licence: TX 8956) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-09-20 |