| NPI | 1881820785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 10673) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 5188) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2023-02-06 |