NPI | 1275576936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ DC5592) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 3235) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2022-04-22 |