NPI | 1235897240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 13829) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 14829) |
Enumeration Date | 2021-12-07 |
Last Update Date | 2021-12-07 |