NPI | 1871542951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: FL CH2508) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: FL CH2508) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2007-07-08 |