| NPI | 1982673547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH5999) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH5870) |
| 171100000X Acupuncturist (Licence: FL CH5870) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2010-08-24 |