NPI | 1235227364 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7077) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3751) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2023-11-08 |