NPI | 1346398088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2008015698) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IN 08002218A) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2023-05-09 |