NPI | 1104571298 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 5426) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 5246) |
Enumeration Date | 2022-02-16 |
Last Update Date | 2022-08-02 |