NPI | 1174791461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1483) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 10824) |
Enumeration Date | 2008-02-20 |
Last Update Date | 2009-04-30 |