NPI | 1114017084 |
---|---|
Other Name | GARY LYMAN SHAW |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IN 08001024) |
Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: IN 08001024) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2007-12-04 |