| NPI | 1588745467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 28305) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY XO10027) |
| 111N00000X Chiropractor (Licence: FL 12911) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-09-03 |