NPI | 1942458401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4437-012) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4437-12) |
Enumeration Date | 2008-09-08 |
Last Update Date | 2021-08-20 |