| NPI | 1730264367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7653) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR005809) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2016-03-11 |