NPI | 1114966827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6209) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 2807) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2009-10-21 |