NPI | 1134201551 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 2469) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC-007686-L) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2007-07-08 |