NPI | 1235216813 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 3698) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 9369) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |