NPI | 1194295592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH12879) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR010131) |
Enumeration Date | 2018-11-28 |
Last Update Date | 2019-08-21 |