NPI | 1528518156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14589) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 4693) |
111N00000X Chiropractor (Licence: TX 13310) | |
Enumeration Date | 2016-10-06 |
Last Update Date | 2025-09-17 |