NPI | 1558587162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH 6258) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: FL CH 6258) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2009-05-04 |