| NPI | 1598097586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 5081) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9775) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2020-07-30 |