| NPI | 1508937988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9532) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-009052) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2016-12-01 |