NPI | 1659479509 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 2921) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NH 747-0905) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2019-02-21 |