NPI | 1245221431 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: CO 6601) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC25280) |
Enumeration Date | 2005-11-04 |
Last Update Date | 2014-06-04 |