| NPI | 1881668572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH0005849) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA 2800) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2008-07-14 |