NPI | 1316491939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 5251-12) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO chr.0007479) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2018-04-11 |