NPI | 1760791214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NC 4260) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC010316) |
Enumeration Date | 2010-10-01 |
Last Update Date | 2020-01-20 |