NPI | 1457030736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NE 2194) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 121215) |
Enumeration Date | 2023-07-14 |
Last Update Date | 2024-11-14 |