NPI | 1659371003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC32243) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH8980) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2012-12-13 |