NPI | 1649810078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IN 08003169A) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0008127) |
Enumeration Date | 2020-01-14 |
Last Update Date | 2020-10-02 |