NPI | 1477218170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 4453) |
Additional Taxonomies | 111NP0017X Chiropractor Pediatric Chiropractor (Licence: OK 4453) |
Enumeration Date | 2021-11-08 |
Last Update Date | 2021-11-15 |