| NPI | 1548585797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NN0400X Chiropractor, Neurology (Licence: FL CH10093) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: CA DC31069) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2019-02-28 |