NPI | 1114195310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MT 1181) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: MT 1181) |
111NR0200X Chiropractor, Radiology (Licence: MT 1181) | |
Enumeration Date | 2008-02-11 |
Last Update Date | 2008-02-14 |