| NPI | 1558675371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 10345) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008697) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2011-07-07 |