NPI | 1487637815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 10850) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 847) |
111N00000X Chiropractor (Licence: MI 2301004362) | |
Enumeration Date | 2005-11-21 |
Last Update Date | 2013-04-11 |