NPI | 1134299340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WV 312) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: WV 312) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2023-10-09 |