| NPI | 1992806392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH3063) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: FL CH3063) |
| 202C00000X Independent Medical Examiner (Licence: FL CH3063) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2018-06-16 |