NPI | 1093805178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11178) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH00034742) |
111N00000X Chiropractor (Licence: OR 713689) | |
Enumeration Date | 2006-10-13 |
Last Update Date | 2023-01-14 |