| NPI | 1578794343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor Independent Medical Examiner (Licence: FL CH5333) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: FL CH5333) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2009-07-28 |