NPI | 1245634567 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2438) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: AL 2438) |
Enumeration Date | 2014-10-15 |
Last Update Date | 2014-10-15 |