NPI | 1053786210 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9227781) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7990) |
Enumeration Date | 2015-12-14 |
Last Update Date | 2015-12-14 |