NPI | 1104122530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6811) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CO chr-6811) |
Enumeration Date | 2011-02-02 |
Last Update Date | 2013-06-28 |