NPI | 1518146307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 4330) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 2209) |
Enumeration Date | 2007-10-29 |
Last Update Date | 2020-12-21 |