| NPI | 1821408832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 4184) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11194) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2017-02-10 |