| NPI | 1821336728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13477) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA 60330707) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2022-12-12 |