| NPI | 1831397991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9363) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR007476) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2012-03-28 |