NPI | 1326080763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000249) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY XX0111741) |
111N00000X Chiropractor (Licence: HI 1071) | |
Enumeration Date | 2006-06-11 |
Last Update Date | 2024-06-19 |