NPI | 1598915241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 2107) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 14070) |
111N00000X Chiropractor (Licence: UT 71183171202) | |
Enumeration Date | 2008-09-30 |
Last Update Date | 2022-07-21 |