NPI | 1942706692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2018003110) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 13770) |
Enumeration Date | 2018-04-02 |
Last Update Date | 2019-05-18 |