NPI | 1215115738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 2061) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 3961) |
Enumeration Date | 2008-02-06 |
Last Update Date | 2022-07-21 |