NPI | 1497464176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0008611) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 14858) |
Enumeration Date | 2022-11-21 |
Last Update Date | 2023-05-17 |