| NPI | 1710054234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 2274) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8931) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-10-07 |