NPI | 1003098658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9373) |
Enumeration Date | 2007-12-05 |
Last Update Date | 2022-03-29 |