NPI | 1831520311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14114) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00724100) |
111N00000X Chiropractor (Licence: MN 5849) | |
Enumeration Date | 2013-12-09 |
Last Update Date | 2023-07-26 |