NPI | 1215234513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2011026702) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: MD S03878) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-02-22 |
Last Update Date | 2017-12-08 |