NPI | 1023074333 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F1-0000237) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003709L) |
Enumeration Date | 2006-04-25 |
Last Update Date | 2007-07-08 |