NPI | 1699719732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 1542) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR004974) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2022-06-14 |