| NPI | 1518002971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11084) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2003031904) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2014-02-17 |