| NPI | 1881864569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH13241) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556602) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2021-01-15 |