NPI | 1255368718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NM 1691) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 0104408) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2008-01-18 |