NPI | 1033285259 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 1960) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001876) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2011-04-20 |