NPI | 1316357775 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11196) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: LA 1742) |
Enumeration Date | 2014-05-06 |
Last Update Date | 2021-02-17 |