| NPI | 1821461229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11703) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR009604) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2015-11-18 |