| NPI | 1689984551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: FL CH10329) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001860) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2025-04-07 |