| NPI | 1487948204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11188) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011921) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2014-06-12 |