NPI | 1215127618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: KY 5177) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AR 1699) |
Enumeration Date | 2007-07-31 |
Last Update Date | 2015-02-18 |