NPI | 1932762929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR.0008562) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 6604) |
Enumeration Date | 2019-04-16 |
Last Update Date | 2022-10-06 |