NPI | 1376679449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR001689) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH3044) |
111N00000X Chiropractor (Licence: MI 2301006749) | |
111N00000X Chiropractor (Licence: AZ 03525) | |
111N00000X Chiropractor (Licence: CO 3931) | |
Enumeration Date | 2007-02-26 |
Last Update Date | 2019-07-03 |