NPI | 1144265174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1143) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008002) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2022-09-13 |