NPI | 1003096637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0400X Chiropractor Rehabilitation (Licence: CA DC-30742) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC-30742) |
Enumeration Date | 2007-11-12 |
Last Update Date | 2010-10-27 |