NPI | 1104883164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5935) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: AZ 1058) |
Enumeration Date | 2006-04-26 |
Last Update Date | 2007-07-08 |