| NPI | 1932311172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL ch06001) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: FL ac01414) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-05-13 |