NPI | 1962896571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8661) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B01578) |
Enumeration Date | 2015-03-20 |
Last Update Date | 2018-03-17 |