| NPI | 1700948403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH6164) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL CH6164) |
| 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH6164) | |
| Enumeration Date | 2006-12-16 |
| Last Update Date | 2026-08-28 |