NPI | 1164544896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: DE F10000281) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003923L) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2013-09-30 |