NPI | 1104501667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: HI 1610) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 2813) |
Enumeration Date | 2023-06-21 |
Last Update Date | 2024-07-13 |