NPI | 1275884819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NH 946) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 3382) |
Enumeration Date | 2012-09-23 |
Last Update Date | 2015-07-28 |