NPI | 1871599191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH100034) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 8900) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2021-05-19 |