NPI | 1003896309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH15113) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2018030044) |
111N00000X Chiropractor (Licence: KS 01-04718) | |
Enumeration Date | 2006-01-20 |
Last Update Date | 2025-02-10 |