| NPI | 1811449119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11991) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH DC-04811) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2023-06-15 |