| NPI | 1922327899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL Ch13697) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00683500) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2024-12-27 |