| NPI | 1831520311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14114) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00724100) |
| 111N00000X Chiropractor (Licence: MN 5849) | |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2023-07-26 |