NPI | 1174600050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: VT 006-0001184) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: VT 60001148) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2023-10-19 |