NPI | 1467508960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TN 2712) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO 5027) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2022-07-21 |