NPI | 1730456419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NE 1811) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IA 007468) |
Enumeration Date | 2011-11-22 |
Last Update Date | 2017-03-21 |