NPI | 1174750632 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6667) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MI 2301009571) |
Enumeration Date | 2009-06-11 |
Last Update Date | 2011-08-09 |