NPI | 1750748372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WY 832) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 14619) |
Enumeration Date | 2016-01-27 |
Last Update Date | 2022-10-05 |