NPI | 1134206808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3226) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001688) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2009-05-06 |