| NPI | 1841608411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TN DC0000002769) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11099) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-09-08 |