| NPI | 1841328986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9253) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL CRT31532) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-09-11 |