| NPI | 1922143668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: FL CH-10813) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 3705) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2023-01-31 |