NPI | 1518407469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 002000) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X012817) |
Enumeration Date | 2017-02-26 |
Last Update Date | 2021-04-26 |