NPI | 1538399258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MT 2363) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9663) |
111N00000X Chiropractor (Licence: NC 4228) | |
Enumeration Date | 2009-07-15 |
Last Update Date | 2014-06-04 |