| NPI | 1518901487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9212) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038011304) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-11-12 |