NPI | 1164537130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 44421) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104000271) |
111N00000X Chiropractor (Licence: DC CH30035) | |
171100000X Acupuncturist | |
171100000X Acupuncturist | |
208100000X Physical Medicine & Rehabilitation (Licence: DC 17362) | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2019-05-16 |