NPI | 1205139904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 10187) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 012251) |
Enumeration Date | 2010-12-19 |
Last Update Date | 2013-02-04 |