NPI | 1538635073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: FL CH12813) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2018-10-23 |
Last Update Date | 2025-03-21 |