| NPI | 1851893168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13180) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NH 1015) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2022-08-19 |