NPI | 1144385410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 1339) |
Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: NM 1339) |
111NS0005X Chiropractor, Sports Physician (Licence: NM 1339) | |
Enumeration Date | 2006-12-27 |
Last Update Date | 2008-02-08 |