NPI | 1558378745 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH9276) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT19489) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2009-02-25 |