| NPI | 1689733651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13182) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD S01967) |
| 171100000X Acupuncturist (Licence: FL CH13182) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-06-01 |