NPI | 1164820148 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 5599) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH60514800) |
Enumeration Date | 2014-12-08 |
Last Update Date | 2024-05-10 |