NPI | 1568670990 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OH 3598) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KY 5125) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2022-07-21 |