| NPI | 1497811947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: RI RI 356) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 7285) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2007-07-08 |