NPI | 1114070679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3631) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: DE F1-0000491) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2018-03-06 |