NPI | 1548358989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 1251) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-137625) |
163W00000X Registered Nurse (Licence: FL 9351425) | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2013-12-19 |