| NPI | 1538289582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9623) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 4487) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2009-07-28 |