NPI | 1720335466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TN DC0000002794) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 4329) |
Enumeration Date | 2012-08-13 |
Last Update Date | 2015-02-10 |