NPI | 1588674394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 2681) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: RI DCP00462) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2020-03-12 |