NPI | 1386875284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 3977) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: LA 1539) |
Enumeration Date | 2009-07-27 |
Last Update Date | 2020-04-29 |