| NPI | 1740502434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 4573) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MS 1180) |
| 111N00000X Chiropractor (Licence: FL CH 9220) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2020-11-17 |