NPI | 1386978179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: AR 15642) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AR 15642) |
Enumeration Date | 2009-09-25 |
Last Update Date | 2025-08-29 |