NPI | 1346636149 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1775) |
Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: LA 4762653906) |
Enumeration Date | 2015-04-09 |
Last Update Date | 2025-08-14 |