NPI | 1932385580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 12257) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL 14564) |
1041C0700X Social Worker Clinical (Licence: ME LC11454) | |
1041C0700X Social Worker Clinical (Licence: GA CSW004131) | |
Enumeration Date | 2008-01-14 |
Last Update Date | 2018-07-26 |