NPI | 1265511836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 005258) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AL 890) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2007-07-08 |