NPI | 1174517858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA 470) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: ID ACC-57) |
Enumeration Date | 2005-09-08 |
Last Update Date | 2010-06-28 |