NPI | 1902090756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH14051) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2218) |
Enumeration Date | 2007-09-04 |
Last Update Date | 2023-05-05 |