NPI | 1003914409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 2656) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: MN 848) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2019-05-09 |