NPI | 1871620187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 8304) |
Additional Taxonomies | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant (Licence: TX 1193) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2019-11-04 |