| NPI | 1669799607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NI0900X Chiropractor Internist (Licence: FL CH9773) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9773) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2017-11-14 |