| NPI | 1922343706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH112187) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PR 509) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2020-04-09 |