| NPI | 1790963858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11895) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IA A05255) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2022-07-21 |