NPI | 1306802970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MD S02178) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5777) |
Enumeration Date | 2006-04-24 |
Last Update Date | 2020-06-14 |