NPI | 1285664714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X2977) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: FL CH4016) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2007-07-08 |