NPI | 1801286273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010985) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA AJ010758) |
Enumeration Date | 2015-01-23 |
Last Update Date | 2015-01-23 |