NPI | 1275660391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 0795) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: LA 795) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2011-02-25 |