NPI | 1316322282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 5727) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32888) |
111N00000X Chiropractor (Licence: NJ 38MC00710400) | |
Enumeration Date | 2015-07-21 |
Last Update Date | 2024-04-13 |