NPI | 1386612992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1150) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: LA 1150) |
Enumeration Date | 2006-03-09 |
Last Update Date | 2023-11-22 |