| NPI | 1760936249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: FL CH11916) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: FL CH11916) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |