| NPI | 1952591257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH12091) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008191) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2017-03-30 |