| NPI | 1699787010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9264) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008062) |
| 171100000X Acupuncturist (Licence: FL CH9264) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-06-14 |