| NPI | 1558516542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9975) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X010211-1) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2016-04-26 |