NPI | 1235684317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 4399) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 2750) |
Enumeration Date | 2016-08-18 |
Last Update Date | 2019-01-04 |