NPI | 1598917676 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301009554) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 10924) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2024-04-11 |