NPI | 1003147141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 32223) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NE 1609) |
Enumeration Date | 2010-01-28 |
Last Update Date | 2013-10-10 |