| NPI | 1942394705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3913) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 3424) |
| 111N00000X Chiropractor (Licence: FL CH8816) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-01-15 |