NPI | 1356643183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH11606) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008754) |
Enumeration Date | 2010-11-30 |
Last Update Date | 2017-01-24 |