| NPI | 1710016365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13325) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X0062661) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2023-05-10 |