| NPI | 1528209178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN DC2224) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH10592) |
| 171100000X Acupuncturist (Licence: TN ACU339) | |
| 171100000X Acupuncturist (Licence: FL AP3138) | |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2022-07-21 |