NPI | 1386222164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34516) |
Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: CA 34516) |
111NX0100X Chiropractor, Occupational Health (Licence: CA 34516) | |
Enumeration Date | 2021-03-31 |
Last Update Date | 2021-03-31 |