| NPI | 1508980558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13493) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC26497) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-08-31 |