NPI | 1487666426 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA CHI718) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NH 270-0687B) |
111N00000X Chiropractor (Licence: MA 718) | |
Enumeration Date | 2006-08-11 |
Last Update Date | 2024-10-31 |