NPI | 1811524374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14479) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00769200) |
Enumeration Date | 2020-03-25 |
Last Update Date | 2024-08-10 |