NPI | 1598301301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC011631) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WA CH61013340) |
Enumeration Date | 2019-11-27 |
Last Update Date | 2021-06-21 |