NPI | 1922111749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH12775) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MT 1112) |
111N00000X Chiropractor (Licence: ID CHIA-1670) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2019-04-22 |