NPI | 1861371643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 6465) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 013718) |
Enumeration Date | 2025-08-27 |
Last Update Date | 2025-08-27 |