NPI | 1093843302 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 27-3072) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 20436) |
111N00000X Chiropractor (Licence: CO 4556) | |
Enumeration Date | 2007-02-28 |
Last Update Date | 2007-09-28 |