NPI | 1811446461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10011060) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x012870) |
Enumeration Date | 2016-09-23 |
Last Update Date | 2022-08-14 |