NPI | 1346555257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11812) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4630-012) |
Enumeration Date | 2010-08-16 |
Last Update Date | 2019-12-10 |