| NPI | 1942519780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH10514) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-011761) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2015-11-30 |