| NPI | 1740412881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY X011705) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch13308) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2023-11-14 |