| NPI | 1710213277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9814) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301009606) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2021-03-22 |