| NPI | 1720763915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14984) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104557838) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2025-02-20 |