NPI | 1922422823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2576) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 11116) |
Enumeration Date | 2014-02-12 |
Last Update Date | 2019-03-05 |