NPI | 1255494167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 7230) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32769) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2025-08-20 |