NPI | 1669585691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 476) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL ch4616) |
111N00000X Chiropractor (Licence: NY X003820-1) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2011-10-09 |