| NPI | 1780854018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch9805) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NE 1499) |
| 111N00000X Chiropractor (Licence: AR 1730) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2012-04-11 |