| NPI | 1548231012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104556345) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 004337) |
| 111N00000X Chiropractor (Licence: FL CH12425) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2018-11-13 |