NPI | 1992974067 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3294) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9509) |
111N00000X Chiropractor (Licence: NC 3784) | |
Enumeration Date | 2008-02-22 |
Last Update Date | 2008-07-03 |