NPI | 1588702732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: DE LG-0012393) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F1-0000485) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2023-08-09 |