NPI | 1275771685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11671) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH9553) |
Enumeration Date | 2009-01-23 |
Last Update Date | 2019-11-20 |