NPI | 1962567594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CHOOO3132) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X002238-1) |
Enumeration Date | 2006-12-26 |
Last Update Date | 2007-07-08 |